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Cleft Lip Repair, Both Sides, First Stage

Pennsylvania rates for HCPCS 40702

Repairs a cleft, or gap, running through both sides of the upper lip in a child, bringing the separated tissue and muscle together and shaping a natural lip border. This is planned as the first of two operations, with the second completing the repair later. It is the child's first repair of the lip rather than a revision of earlier surgery.

Rates data updated July 2026.

How much does Cleft Lip Repair, Both Sides, First Stage cost?

$1,413

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1,413 for this service. The price depends on where it is billed: about $1,023 from a physician practice, and about $4,786 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,023$933 to $1,259
FacilityA hospital or hospital-owned outpatient department$4,786$2,951 to $6,761

How much rates vary

Facilitymedian $4,786 · 10th to 90th $1,047 to $8,318Professionalmedian $1,023 · 10th to 90th $871 to $1,738
$1K$2K$5K$10Kfacility $4,786professional $1,023

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$4,786.30
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,023.29
Typical High
$1,584.89
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$10,000.00
Typical High
$57,543.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,071.52
Typical High
$1,698.24
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$1,548.82
Typical High
$1,548.82
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,202.26
Typical High
$1,659.59
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$3,981.07
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,122.02
Typical High
$5,370.32
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,096.48
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$4,786.30
Typical High
$8,317.64
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$977.24
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$5,370.32
Typical High
$17,378.01
United
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,071.52
Typical High
$1,905.46

Where Pennsylvania sits

The same service costs 6.6 times more in California than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 33rd of 51

$1,413

CA $6,457WV $977

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.